Happy Holidays! Enjoy Time with Family & Friends - I'll Be Back Next Week

 As I usually do at this time of year... I am taking this week off to spend time with loved ones and to recharge the creative batteries.  

IF there is something Earth shattering that occurs in the next few days, I'll be here to report and give my take on it, but barring anything that is hugely tech or news worthy, I'll be taking a bit of 'Blog Vacation'.

Thanks to all of you that read and support me.  You guys and gals mean more to me than I can tell you.  If you didn't take the time to read and reach out to me, I would be toiling away for naught.  Knowing that you good folks read my ramblings is hugely important to me.

See you in 2022!!!

It's the Most Wonderful Time of the Year - NORAD Tracks Santa!!!

 

Every year on December 24th... the moment it begins at the International Date Line, NORAD begins tracking Santa as he delivers gifts around the globe!  The Santa Tracker shows kiddos exactly *where* Santa is on every part of his trip as well as providing videos of him as he passes famous landmarks.

Until Christmas Eve kids can also explore the website, listen to music, and play games!

The origin story of the entire process will fascinate adults.  Find out about the mission by following this link.

And the main page with all of the goodies as well as the Santa Tracker can be found here!

May all your holidays be merry and bright!

Carestream Dental Announces Sale of Scanning Technology Business

 

This one is hot off the press.  Carestream is selling their scanning business to Envista Holding which is the parent company of Kavo-Kerr.  More info to follow as it is available...

Affiliates of Carestream Dental LLC (“Carestream Dental”) today announced that they have entered into an agreement to sell Carestream Dental’s Scanning Technology business to Envista Holding Corporation (“Envista”), a leading global dental products company for $600 million. The Scanning Technology business is composed of Carestream Dental’s intraoral scanner equipment (CS 3600, CS 3700, and CS 3800) and related software.

 Carestream Dental will continue to operate its market-leading imaging technology, clinical software and practice management software businesses which provide innovative solutions for dental practices, groups, DSOs and industry partners. The sale of the Scanning Technology business will not only deliver significant proceeds representing the value of the company’s innovation processes, but also allow Carestream Dental to focus its investments and efforts in the highly attractive and growing dental cloud and technology solutions market. Its recent investments in Sensei Cloud practice management and Swissmeda’s suite of clinical software solutions complement a legacy of market-leading device innovation with new growing SaaS applications focused on helping practices and groups build new revenue, profits and patient flows.

 “This is an exciting time for Carestream Dental and our customers,” Lisa Ashby, CEO of Carestream Dental, said. “We’ve had a multi-year investment plan in cloud solutions and technology, and this transaction allows us to better focus and accelerate our innovation in AI tools, clinical cloud applications and cloud practice management for GPs, DSOs and specialty practices. We will continue to work together with our customers and partners to create innovation which delivers both clinical and operational value, and think Envista represents a great home for our Scanning Technology business under which our employees and customers will thrive.”

 Subject to legal, regulatory and employee consultation requirements, it is anticipated that the transaction will close in late Q1/early Q2 of 2022. Additional terms of the transaction were not disclosed. Jefferies LLC is serving as financial advisor and Debevoise & Plimpton LLP is serving as legal counsel to Carestream Dental in the transaction.

 

One of My Top Test Drives of 2021 - Monet Handheld Curing Laser

As I’ve said in the past, curing is the stepchild of adhesive dentistry.  It’s always there, but no one ever pays any attention to it.  We’ve seen some pretty dramatic improvements in our curing devices over the past decade, but AMD has leap frogged the industry with the first laser that is the same size as the standard LED curing light.

A laser pushes all of its photons in one direction in a column of light.  Due to that, every photon created goes to the process of curing the composite.  The physics of LED lights means that as soon as the light leaves the LED, it begins to sort of “spray” in all directions.  That means wasted photons which do NOT help cure the composite.  The Monet focuses all of those photons in a single column of light.

Because of the intensity of the beam, AMD’s internal testing shows a depth of cure of at least 4mm.  In my own independent testing, I have seen similar numbers.

In situations where a Class II restoration is placed, most of us cure from multiple directions after we remove the “hardware” of our matrix system.  The idea is that coming at restorations from the  lingual, buccal, and occlusal gives us the best chance of ensuring an adequate cure.  Adding a curing laser to that equation means better depth of cure across the entire restoration.

The Monet also comes with some handy “aperture attachments” that can easily snap on over the curing lens.  These little clip-on attachments reduce the diameter of the beam to create different aperture tacking tips or smaller beams for more precise curing.

In addition to being a benefit for direct restorations, the Monet has benefits for indirect restorations as well.  The intensity of the beam assures the operator of a strong bond and effective photopolymerization even through thick restorations such as onlays.  This means that the user can have confidence that the restoration has a strong bond and is not relying on autopolymerizing resins to complete their chemical curing process. Lasers are truly the “next step” in our curing armamentarium.

Bayer Consumer Health Division Announces Clinical Research Study Findings Evaluating Naproxen Sodium vs. an Opioid Combination in Acute Postsurgical Dental Pain

Study Shows a Single Dose of Over-The-Counter Naproxen Sodium (440 mg) is as Effective, Lasts Longer, and was Better Tolerated Than a Single Dose of a Commonly Prescribed Opioid

Bayer Consumer Health Division announced today its clinical research study, "Analgesic efficacy of naproxen sodium versus hydrocodone/acetaminophen in acute postsurgical dental pain: a randomized, double-blind, placebo-controlled trial" was published online in the Postgraduate Medicine journal.

Aleve® is an over the counter (OTC) pain reliever indicated for temporary relief of minor aches and pains including minor arthritis pain, headache, muscular aches and toothache. The single dose study found that in treating moderate-to-severe postsurgical dental pain, a single dose of non-prescription naproxen sodium 440 mg (NapS) was at least as effective at hours 0-4 and better tolerated than a single dose of an opioid combination of hydrocodone plus acetaminophen 10/650 mg (HYD+APAP). This class of medication is known to lead to the potential for misuse and addiction.1 

Overall, in a single dose study, NapS was as effective as HYD+APAP during hours 0-4, and longer lasting. NapS was found to meet the endpoints of reducing pain intensity over 12 hours (primary endpoint; p=0.01), total pain relief over 6 and 12 hours (p<0.05), time to rescue medication (p<0.001), and duration of pain at least half gone over 12 hours (p<0.001). The HYD+APAP treatment was not statistically superior to NapS for any endpoint. Additionally, more treatment-related adverse events were reported with HYD+APAP (n=63) than NapS (n=2) and placebo (n=20), including nausea, vomiting, and dizziness. Results showed NapS to be statistically superior to HYD+APAP for the primary and key secondary endpoints and to have a lower incidence of adverse events (14.4% vs. 39.1%).

"We set out to understand how NapS compares with a common opioid combination in dental pain. We were pleased that the results showed that NapS performed as well as it did in the study," said Charlene Ng, Interim Head of North America Medical Affairs, Bayer Consumer Health. "Knowing NSAIDs are commonly recommended as a first line of defense following dental procedures, we wanted to see how one dose of NapS directly compares to one dose of a commonly prescribed opioid combination. The study yielded positive findings that can serve as valuable information for dental professionals when determining the appropriate treatment for their patients."

One of the most common reasons patients seek medical attention is for pain relief.2 Fast and effective management of acute pain is critical to minimize negative side-effects and current treatment guidelines worldwide recommend that first-line therapy in all mild-to-moderate pain conditions in adults should be oral non-steroidal anti-inflammatory drugs (NSAIDs) and/or acetaminophen (APAP). 3-5 Opioids, however, alone or in combination with other analgesics, continue to be prescribed for pain relief. Overprescribing opioids has led to unprecedented levels of relief which have the potential for addiction. 

The results of this single dose study demonstrate that NapS provides the same levels of pain relief from hours 0-4 as a commonly prescribed opioid combination for acute postoperative pain and can be considered by clinicians when recommending appropriate analgesics for minor pain.

"This study comes at a key time, as opioid addiction and overdose deaths have been declared a public health emergency in the United States2," said Dr. M. Ted Wong, DDS, MHA, oral healthcare and dental medical integration consultant. "In reviewing the results, the study shows that NapS may be an effective non-addictive treatment option for those undergoing dental procedures. Data like this is key in the ongoing effort to mitigate the use of opioid combinations as a first line of defense for relieving minor pain after dental procedures. It is my hope that other dentists find the results as compelling as I do."

About the Study 

The study titled, "Analgesic efficacy of naproxen sodium versus hydrocodone/acetaminophen in acute postsurgical dental pain: a randomized, double-blind, placebo-controlled trial," was a single center, randomized, double-blind, and placebo-controlled study in moderate or severe postoperative pain after the surgical removal of impacted third molars. Patients (n=212) received either a single dose of NapS (Aleve®, Bayer Bitterfeld, Germany; 220 mg x two tablets), HYD+APAP (Norco®, Amneal Pharmaceuticals, NY, USA; 5+325 mg x two tablets), or a placebo within 4.5 hours post-surgery and were assessed over the course of 12 hours. The primary endpoint was the summed pain intensity difference from zero to 12 hours (SPID0-12) with secondary endpoints identified as pain intensity, pain relief, time to rescue medication (additional pain relief medication taken, if needed), and duration of pain at least half gone. Additional endpoints assessed include onset of pain relief, global assessment of treatment, and adverse events.

There were no serious adverse events (AEs) or treatment-emergent adverse events (TEAEs) that led to study discontinuation. A total of 85 TEAEs were reported (NapS, n=2; HYD+APAP, n=63; PBO, n=20). Most AEs were classified as mild, but moderate in 21.8% HYD+APAP patients and 13.6% of PBO patients. Results demonstrated that NapS was better tolerated than HYD+APAP with only one AE that was considered treatment related (somnolence) compared to 18 with HYD+APAP (mostly nausea, vomiting and dizziness) and compared to 1 with PBO (vomiting).

About Bayer

Bayer is a global enterprise with core competencies in the life science fields of health care and nutrition. Its products and services are designed to help people and planet thrive by supporting efforts to master the major challenges presented by a growing and aging global population. Bayer is committed to drive sustainable development and generate a positive impact with its businesses. At the same time, the Group aims to increase its earning power and create value through innovation and growth. The Bayer brand stands for trust, reliability and quality throughout the world. In fiscal 2020, the Group employed around 100,000 people and had sales of 41.4 billion euros. R&D expenses before special items amounted to 4.9 billion euros. For more information, go to www.bayer.com.

ADA Sends Letter to Senate Encouraging Passing Bill "Prevent HPV Cancers Act"

 

On December 10, 2021 ADA President Cesar Sabates, DDS wrote to the majority and minority leaders of the senate to encourage passage of H.R.1550.

The Human Papilloma Virus is estimated by the Centers for Disease Control to cause oral cancers in 19,000 U.S. citizens yearly.  We have a vaccine for this virus & we need to get the population vaccinated.  Oral cancers have a low 5 year survival rate, mainly because many people do not see a dentist regularly and discover the signs when the disease is at a more advanced stage.

Here is the letter sent by Dr. Sabates (who I am proud to call my friend):

Dear Majority Leader Schumer and Minority Leader McConnell: 

On behalf of the 162,000 members of the American Dental Association (ADA), we are writing to ask you to bring H.R. 1550, the PREVENT HPV Cancers Act, to the floor for a vote. The ADA strongly supports this legislation that passed the House of Representatives by voice vote on November 30. 

The ADA believes in the importance of increasing awareness of HPV and of educating the public on the need for HPV immunization. The administration of the HPV vaccine is a safe and effective way to reduce the risk of HPV-related cancers, including certain head and neck cancers. HPV is now associated with more than 19,000 cases of head and neck cancer each year in the United States, according to the Centers for Disease Control and Prevention (CDC). 

H.R. 1550 would provide the national public awareness needed to help Americans safeguard their oral health against cancers of the mouth, throat, and tonsils. The ADA is proud to support H.R. 1550 and would welcome the opportunity to work with the Secretary of Health and Health Human Services (HHS) on the public service awareness campaign that would be authorized under the bill. 

We urge you to bring the PREVENT HPV Cancers Act up for a vote. Thank you for your consideration, and please do not hesitate to contact Ms. Natalie Hales with any questions at halesn@ada.org.

Sincerely,

Cesar R. Sabates, DDS

Ultradent Grows its South Jordan Campus

 Ultradent Products, Inc., a leading developer and manufacturer of high-tech dental materials and equipment, is beginning construction of a new facility on its South Jordan, UT, campus. A groundbreaking ceremony will be held December 16, 1:30 p.m. with key company representatives and local leaders in attendance. 

The planned 170,000 square feet, state-of-the-art building will allow Ultradent to expand its growing manufacturing division—housing injection molding, equipment manufacturing, repair facilities, and more. The building will support 24/7 operations to facilitate Ultradent’s increasing domestic and international presence. The building—designed by PGA&W Architecture—is expected to be completed in early 2023.

Statement from CISA Director Easterly on "LOG4J" Vulnerability

 The world of cyber security is full of twists and turns.  It's also a never ending battle as experts for legitimate entities try to keep criminals out of their networks.  Recently we've seen an uptick in 'supply chain attacks' where the hackers infiltrate systems through a trusted IT partner.

These attacks allow a hacker to exploit a single company and have that particular exploit then delivered to many other companies.  It's a nefarious way of spreading mayhem and creating possibilities for exponential incidents of Ransomware or other Malware.

We are currently seeing a *major threat* through an exploit that is being referred to as a "critical vulnerability".  I've read one story online that quotes CISA Director Jen Easterly as saying this could well be the worst vulnerability she has seen in her career.  Here is the statement that was released by CISA.  You may want to check with your IT folks to see if this affects you...

Cybersecurity and Infrastructure Security Agency (CISA) Director Jen Easterly released the following statement today on the “log4j” vulnerability: 

 “CISA is working closely with our public and private sector partners to proactively address a critical vulnerability affecting products containing the log4j software library. This vulnerability, which is being widely exploited by a growing set of threat actors, presents an urgent challenge to network defenders given its broad use. End users will be reliant on their vendors, and the vendor community must immediately identify, mitigate, and patch the wide array of products using this software.  Vendors should also be communicating with their customers to ensure end users know that their product contains this vulnerability and should prioritize software updates. 

 “We are taking urgent action to drive mitigation of this vulnerability and detect any associated threat activity. We have added this vulnerability to our catalog of known exploited vulnerabilities, which compels federal civilian agencies -- and signals to non-federal partners -- to urgently patch or remediate this vulnerability. We are proactively reaching out to entities whose networks may be vulnerable and are leveraging our scanning and intrusion detection tools to help government and industry partners identify exposure to or exploitation of the vulnerability.  

 “The Joint Cyber Defense Collaborative is designed to manage this kind of risk. We have established a JCDC senior leadership group to coordinate collective action and ensure shared visibility into both the prevalence of this vulnerability and threat activity. By bringing together key government and private sector partners via the JCDC, including our partners at the FBI and NSA, we will ensure that our country’s strongest capabilities are brought to bear in an integrated manner against this risk. To ensure the broadest possible dissemination of key information, we are also convening a national call with critical infrastructure stakeholders on Monday afternoon where CISA’s experts provide further insight and address questions.  

 “We continue to urge all organizations to review the latest CISA current activity alert and upgrade to log4j version 2.15.0, or apply their appropriate vendor recommended mitigations immediately.

 “To be clear, this vulnerability poses a severe risk. We will only minimize potential impacts through collaborative efforts between government and the private sector. We urge all organizations to join us in this essential effort and take action.” 

 CISA recommends asset owners take three additional, immediate steps regarding this vulnerability: 

   1. Enumerate any external facing devices that have log4j installed. 

   2. Make sure that your security operations center is actioning every single alert on the devices that fall into the category above. 

   3. Install a web application firewall (WAF) with rules that automatically update so that your SOC is able to concentrate on fewer alerts. 

 This effort also underscores the urgency of building software securely from the start and more widespread use of Software Bill of Materials (SBOM), both of which were directed by President Biden in his Executive Order issued in May 2021.  A SBOM would provide end users will the transparency they require to know if their products rely on vulnerable software libraries. 

Evaluating AirFree Air Purifiers in Our Clinic

 

Obviously, air quality has come to the forefront of infection control recently.  If you think about it logically, masks are all about air quality.  Some are for outgoing and some are for incoming.

A normal surgical mask that does not fit snugly around the face does little to actually protect the wearer (it provides some protection but not a lot), but protects others from respiratory droplets.   While N-95 respirators help protect the wearer (the snug fit and electrically charged filtration remove tiny pieces in the air) while also protecting others.

However, what if there were ways to help cleanse the air in addition to wearing masks?  In the dental environment, that's what we're trying to do by using air purification systems in addition to masks.

We have recently received 2 AirFree Air Purifiers which we are putting to use in our clinic.  The dental office here is divided into what we refer to as "pods".  We have one pod for reception, one pod for the clinic, and one pod for staff.  Each pod is separated from the others by doors and each pod also has its own HVAC system.

Since our clinic is the pod in the office where the aerosols are being created, we have placed an Airfare P  Air Purifier at each end of the clinic pod.  The devices are quiet, since no fans are needed, but they also have a great aesthetic that with the high tech appearance of our office.  The devices work quietly to get rid of up to 99.99% of bacteria, fungi, viruses, pollen, and other air pollutants.

Personally, I love the appearance, but I also love the fact that they are always working to remove anything in the air that can cause problems.

I'll be reporting back in a few weeks to let you know how things are going with them, but at this point we're having good results.

3Shape and Dentsply Sirona Announce Next Step in Dental Connectivity

 Dentsply Sirona and 3Shape have taken the next step according to their agreement and now provide a seamless and secure integration of Dentsply Sirona’s Connect Case Center with 3Shape’s Dental System software. Dentists using Primescan or Omnicam intraoral scanners for digital impression-taking can now give dental labs secure access to the data through the Connect Case Center Portal. That makes it easy and efficient for dental technicians using 3Shape’s software to work more closely with their dental practice partners.

The new interfaces are available to dental laboratories that use 3Shape’s Dental System and have upgraded to Version 2021.2.

“I always want to give a patient the treatment I feel is best for them. When companies like Dentsply Sirona and 3Shape choose to work together, it gives all dentists and lab owners more opportunities, and that means better outcomes for our patients,” said Dr. Alan Jurim, owner of integratedDENTAL (Woodbury, NY).

With integrated hardware and software, even highly complex treatments can be efficiently planned and executed. Simplifying digital workflows, results in a closer working relationship between labs and their dentist partners.

“Digital impressions facilitate communication. After scanning I can discuss the digital model directly with my patient. And because I now can communicate with the lab technician seamlessly, I can share the planned outcome with my patient much quicker – and that is a benefit to the patient that matters,” said Dr. Sabrina Hoffmann, a dentist in Buerstadt, Germany. “What we are experiencing today is truly the dentistry of the future.”

Last June, both companies announced an agreement between the two companies designed to improve digital dentistry and oral health. The goal is to support the dental community through the evolution of efficient, simplified, and digitally oriented workflows for dentists and dental technicians. As a first step, users of 3Shape’s TRIOS intraoral scanner gained validated and seamless access to Dentsply Sirona’s SureSmile Clear Aligners platform, which makes it much easier for 3Shape’s customers to offer patients a leading solution for treating malocclusions.

Both companies are now focusing on expanding customer access to an even wider range of technology choices.

More information about Primescan is available on the Dentsply Sirona Website: www.dentsplysirona.com/primescan

More information about 3Shape’s Lab software is available on the 3Shape website: www.3shape.com/en/promo/dentsply-sirona-connect

Due to the different approval and registration times, not all technologies and products are immediately available in all countries.

Clear Aligners Market Size Worth $17.0 billion By 2028: Grand View Research, Inc.

 The world of orthodontics has changed radically in the 2 decades since the year 2000.  The technology of computerized treatment planning and 3D printing brought for the concept of the clear aligner.  This was aided by advancements in chemistry that allowed for development of resins that could actually move teeth.

Jumping forward 20 years and we now have multiple companies competing in the clear aligner space.  The biggest boon to the clear aligner process has been the advancements and market penetration of 3D intraoral acquisition units.  In the old days traditional analog impressions were taken and sent to a company who then poured them up into plaster models.  Those models were then scanned to create a digital 3D representation of the mouth which was used to treatment plan and fabricate the aligners.

The proliferation of incredibly accurate 3D intraoral scanners has great simplified and accelerated the treatment.  Now a scan can be uploaded to the aligner company and treatment plan fabricated in hours or less.  This has allowed for "outcome simulators" to show patients anticipated outcomes almost immediately after the scan is completed.

Bringing all of this technology to bear on the subject or orthodontics has triggered explosive growth in the field.  While there are still a few cases that require brackets and wires, most cases can now be treated with a minimally invasive clear aligner solution.

Now comes a new study from Grand View Research, Inc that sees this section of the market growing to $17 billion by the year 2028.  The complete research paper can be downloaded from this link.

Here is the info the company made available from a recent press release:

The global clear aligners market is expected to reach USD 17.0 Billion by 2028, according to a new study by Grand View Research, Inc. It is expected to expand at a CAGR of 27.3% from 2021 to 2028. Clear aligners are invisible and discreet braces developed from thermoformed materials like copolyester or polycarbonate plastic and CAD 3D printing technology, acting as an alternative to traditional braces. According to the FDA, the clear aligner system helps in positioning the teeth by the means of continuous gentle force and is developed to treat mild to moderate malocclusion.

Key Insights & Findings:

• The teenage segment emerged as the largest consumer segment in 2019, as teenagers are increasingly opting for the orthodontic device because of its inconspicuous characteristics and comfort

• The standalone practices segment reciprocated the largest share in 2019 as standalone practitioners are readily adopting the orthodontic device and are equipped with advanced digital technologies

• North America dominated the market in 2019 owing to increasing demand for new technologies, a large pool of key players, rising prevalence of dental disorders, and advanced healthcare infrastructure in the region

• In Asia Pacific, the market is expected to reciprocate the highest CAGR over the forecast period.

Read 100 page research report, "Clear Aligners Market Size, Share & Trends Analysis Report By Age (Adult, Teens), By End-use (Hospitals, Standalone Practices, Group Practices), By Region (North America, Europe, APAC, Latin America, MEA), And Segment Forecasts, 2021 - 2028", by Grand View Research

According to the WHO, malocclusion is the third most prevalent dental disease after dental caries and periodontal disease globally. Malocclusion of the teeth causes the problem of misalignment which can later lead to severe oral health complications like hard and soft tissue trauma. This condition is hereditary and can be passed from one generation to another.

Technological advancements and the growing demand for customized clear aligners are significant factors responsible for market growth. Companies like Align Technology and DynaFlex are constantly bringing in newer computer-aided technology in the market. For instance, the launch of iTero, which is a digital impression system, by Align Technology is assisting in developing accurate, effective, and customized clear aligners. The device is designed in accordance with the wearer's comfort to treat mild to moderate misalignment conditions. According to an article published in Scielo.com in November 2018, the global prevalence of Class I malocclusions is 74.7%, and of Class II malocclusions is 19.6%. The rising prevalence of these medical conditions is assisting in escalating the demand for orthodontic devices.

The demand for customized clear aligners has witnessed a burgeoning growth, especially among teenagers. For instance, the FDA-approved Invisalign clear aligners developed by Align Technology have been used in the treatment of 5.0 million people as of 2018, and worldwide Invisalign shipments to teenagers were about 87.1 thousand cases. To date, over 1.0 million teenagers have adopted this orthodontic treatment. This is because many teenagers prefer avoiding discomfort caused by metal braces and also want their braces to look aesthetically appealing. The above-mentioned factors are cumulatively assisting in robust market growth.

Grand View Research has segmented the global clear aligners market on the basis of age, end-use, and region:

• Clear Aligners Age Outlook (Revenue, USD Million, 2016 - 2028)

◦ Adult

◦ Teenage

• Clear Aligners End-use Outlook (Revenue, USD Million, 2016 - 2028)

◦ Hospitals

◦ Stand Alone Practices

◦ Group Practices

◦ Others

• Clear Aligners Regional Outlook (Revenue, USD Million, 2016 - 2028)

◦ North America

▪ U.S.

▪ Canada

◦ Europe

▪ U.K.

▪ Germany

▪ France

▪ Italy

▪ Spain

◦ Asia Pacific

▪ India

▪ Japan

▪ China

▪ Australia

▪ South Korea

◦ Latin America

▪ Brazil

▪ Mexico

▪ Argentina

◦ Middle East & Africa

▪ South Africa

▪ Saudi Arabia

▪ UAE

List of Key Players of Clear Aligners Market

• Align Technology, Inc.

• Danaher Corporation

• Institut Straumann AG

• Dentsply Sirona

• 3M

• Argen Corporation

• Henry Schein

• TP Orthodontics, Inc.

Orascoptic Endeavour XL Impresses and Continues to Impress

The picture above is my newest "nose light" in my armamentarium of headlights.  This is my new Endeavour XL from  Orascoptic with TruColor.  There is an interesting story behind my latest purchase.

Throughout my career I've used a variety of scope mounted lighting, but my "bread and butter" light was the Orascoptic Zeon Discovery.  The picture is below.

The thing I really liked about the Discovery, was its brightness.  It was a bit heavy on the bridge of my nose, but I was willing to trade that for the intensity of the light.  However, recently the battery had started to degrade and I knew I was going to have to make a change.  Time had passed the Discovery by.

So I invested in the Endeavour XL and the first question that crossed my mind was "why did I wait?"  The Endeavour XL is incredibly bright, so I'm not losing any light intensity.  It's also much smaller and lighter so my scopes aren't as heavy.  One other feature that I need to mention is that the cord is *much* thinner, which means less pull and also less chance of wire breakage from bending.Add to those benefits the fact that the new light also has Orascoptic's Tru Color built in and this thing is an absolute winner.

The advantage of the Tru Color lighting is that the color emitted by the light is very close to natural sunlight.  That makes shade matching a much simpler task.  It is about 5700° Kelvin which many experts consider "true north lighting".

Now I know a lot of you are probably asking why I didn't just go with a wireless system for my lighting and my answer for that is that I am used to working under *very* bright light.  The wireless systems are completely acceptable for every day use.  It's just that I have gotten SO used to working in a bright field that I wanted that intensity as an option.  The Endeavour XL has low, medium, and high settings and I normally use the low option, however I love choices and having the extra brightness can come in handy for some situations so I chose to keep with a system that had that option.

If you are like me and want brightness when you need it, for sure check out the lineup from Orascoptic.  The Endeavour XL is *highly* recommended! 

 

Nobio's Infinix Composite Continues to Impress in Clinical Trial

 

As many of you know, I've been fortunate enough to be able to work with the new composite from Nobio called Infinix.  The cool thing about Nobio is they are not a restorative company, they are a "chemical company".  By that I mean they are not just looking to change dental restoratives, but also to change the way a lot of things are made by adding their bacterial killing molecules to those products.

Infinix is a composite material created to kill bacteria that comes into contact with it.  If it follows through in the real world as it has in the lab, this may be a total game changer for the profession and the patients we serve.

Here in the U.S. I think I might have been the first dentist to actually place an Infinix restoration.  While I am truly honored to be able to say that, I also think that means it's my job to let the rest of the profession know what I've experienced.  

I'll continue to provide updates, but I've got to say that things are "so far, so good".  I'm about 20 restorations into my trial and I have nothing but good things to say at this time.

The above photo shows a MO and DO restoration done with the material.  I currently only have one shade to work with and that is A-2.  I tell you that because in the clinical photo it is easy to spot the material.  The good news is that it is close enough that they are not noticeable except to those in the profession.  The patients who have received these restorations have been very happy with them.  The company is planning on more shades in the future, but at this point, they wanted to get material to me to use and A-2 was the first shade available.

The material handles well.  It is not sticky and is easy to place.  I prefer to use warm composite and I'm happy to say that the warm material handles as expected.  I prefer to prep with a 2-3mm bevel at the cavosurface margin and it finishes very well.  I tend to use micro-fine finishing diamonds first and then to polish with Ultradent Jiffy Polishers finishing with the Jiffy Brush.

The material polishes well and has a nice shine after polish.

The real benefit of course should be the long term viability of the materials.  I am placing these restorations across a wide spectrum of patients and will follow them carefully as they come in for recare.  It's a nice material to use, but my real hope is that it increases the life span of our restorations.

I'll be posting more as my experience progresses...

SprintRay Receives FDA 510(k) Clearance for NightGuard Flex

 

As I stated here recently, I love SprintRay products.  I have been using SprintRay printers in my office for several years now and I am *very* impressed with their performance, quality, and durability.  The printers are, to put it simply, workhorses.  They churn out models, implant surgical guides, occlusal guards, and temporary crowns.

You'll notice the term "occlusal guards" in the above paragraph.  I should specify that the term applies to rigid resin based occlusal guards.  For the non-dentist folks who read the blog I should explain that an occlusal guard is a dental device that a patient wears (normally while sleeping) to protect the teeth from damage caused by clenching and grinding.  I should also explain that  there are 2 types of materials that are used to make these devices.

The first material is hard acrylic.  The idea behind this material is that it is very resilient and can resist strong biting forces that are generated by the patient musculature.  Depending on the material used, hard guides can last for years.  The drawback is that they need to be very well balanced with the biting (occlusal) forces distributed equally.  Basically it needs to be designed and adjusted so that all the teeth touch it equally at the same time.  The main drawback is that patients who are strong grinders can break this material.

The second material, which is what I personally prefer to use, is a softer more rubbery material.  It can act as a "shock absorber" to the teeth, is almost impossible to break, and does not require as much adjustment.

Due to my preference to clinically use softer materials, I was excited to learn that SprintRay recently received FDA 510(k) clearance for a new material Nightguard Flex.  This new resin allows the doctor or the dental lab to 3D print appliances made with a flexible material!  

Here is the info from the SprintRay press release:

SprintRay Inc., an industry leader in digital dentistry and 3D printing solutions, today announced that the United States Food and Drug Administration (FDA) has granted the Company clearance to market its NightGuard Flex 3D printing resin as a Class II medical device in the United States. The SprintRay NightGuard Flex is indicated for the fabrication of orthodontic and dental appliances such as mouthguards, nightguards, and splints, and joins SprintRay's industry-leading line up of end-to-end dental 3D printing solutions.

SprintRay NightGuard Flex resin was developed, in part, to meet the growing demand for night guards due to the COVID-19 pandemic. According to an American Dental Association survey, more than 70 percent of dentists are seeing an increase of patients experiencing teeth grinding and clenching, conditions often associated with stress. SprintRay's NightGuard Flex 3D printing material is a flexible resin for 3D printing night guards and splints. NightGuard Flex is designed to deliver the best possible patient experience with high impact strength and wear resistance, comfortable and flavorless material and same-day patient delivery. Additionally, NightGuard Flex drives greater efficiency for dental practitioners by eliminating the need for third party resins and creating uniform, end-to-end dental 3D printing workflows.

"Nightguards are costly and can take several weeks to get back with traditional production methods using outside sources," said Amir Mansouri, Ph.D., CEO of SprintRay. "Today, Sprintray's NightGuard Flex resin has totally changed the patient and doctor experience in the treatment of bruxism and teeth grinding. Our patient-centered design is durable, flexible, more comfortable, and enables faster delivery and greater access for patients to receive their nightguards same-day, through chairside SprintRay 3D printing and at more affordable prices."

This announcement follows the launch of SprintRay's Protect A Smile campaign, a program designed to support occlusal health through 3D printing, as well as SprintRay's North American distribution partnership agreement with Nobel Biocare, which furthers the Company's mission to increase patient access to innovative dental technology solutions.

The EndoUltra Cordless Ultrasonic Agitator

 

I perform a lot of endodontics in my office.  That simple fact means that I am always looking for ways to improve patient outcomes as well as perform more efficiently.  I think this is especially true when it comes to endodontics.  No one ever wants a root canal "to take longer".

Endodontics requires a high degree of precision and because of that the procedure can be time consuming.  Anything worth doing is worth doing well, but that doesn't necessarily mean that quality always requires a long procedure.

There is also the simple fact of irrigation and chemical cleansing of the canal system.  If you have ever seen a scanning electron microscopic view of a canal system (and you probably have) you'll understand that simple mechanical instrumentation cannot do all the necessary work of removing diseased tissue and bacteria.

Because of that simple fact, irrigation has become tremendously important while performing endodontic treatment.  The other part of irrigation is being sure that the irritants reach into all the small areas of the canal system.  That's why it's not only important to use copious irrigation, it's also important to provide some type of agitation to those irritants.  This ensures that they are replenished in those tiny areas as well as to provide some "shock waves" that also can loosen debris as well as having some potentially lysing effects on bacterial cell walls.

I've used several different devices to accomplish this task, but my current favorite is the EndoUltra from Vista-Apex.  The device is small, ergonomic, wonderfully effective, and affordable.  If you do endo in your practice, effective irrigation and agitation of those chemicals is critical to clinical success.

I have been using the EndoUltra device for about 2 years now and have nothing but good things to say about it.  Take a look at the video I shot this summer to hear all about it.  I was lucky enough to spend some time on a site visit to the Vista-Apex facility this past summer and saw some impressive things.  While there, they asked if I could sit down and do a testimonial video on the EndoUltra and I was happy to do so.  I use it and believe in it, so talking about it was easy.  Give the video a view and I think you'll be as impressed with this device as I am.

An Attempt to Reinsert Dental into Medicare

 I don't normally like to even mention politics on the blog.  Number one, there are enough blogs doing that already.  Number two, I don't like discussing politics.  😃

However, because this is politics that has the definite possibility of affecting dentistry, today we'll wade just a bit into what is going on.

Those of us in the profession are most likely aware that in the beginning of the budgetary debate this fall, there were initial attempts to include dental as part of Medicare.  The American Dental Association was opposed to the way the way it was proposed and worked hard with congress to find a compromise.  I won't go into great detail on all of that here as there are pages and pages of info on this that presents it much better than I can.  Just do a Google search for all the answers.

The heart of the matter today is that the process has hit a snag.  Evidently discussions were held among senators who agreed on the details and things were moving along nicely.  However, now Senator Bernie Sanders has decided to change a part of the bill to try to re-include the Medicare dental piece.

I bring this up so that regular readers here will be aware of the situation.   There is a great explanation of the situation at Bloomberg.com that you can read by following this link...